Since the introduction of the Sunshine Act legislation several years ago, one question has been whether transparency will impact relationships between pharmaceutical and medical device manufacturers and health care providers and entities. Others have wondered whether patients, enforcement authorities and the public at large will be interested in the reported data. While these questions likely will be answered over the next couple of years as reporting begins, no one doubts that the media, social scientists and others will be slicing and dicing the data in order to draw conclusions about these industry relationships. One recent example of this is the report issued on August 2, 2013 by the Social Science Research Network (SSRN) titled, “First, Do No Harm: Financial Conflicts of Medicine”.
The objective of the SSRN report is to analyze whether “doctors with connections to the pharmaceutical industry behave differently than those lacking such financial relationships.” The SSRN report also takes the additional step of trying to determine from the data the reason for these payments, whether “paying for a doctor’s expertise”, “advertising”, or “rent-seeking.” To answer these questions, the report authors looked at payments reported by 12 pharmaceutical companies from the time period 2009 – 2011, and compared it to physician prescription data for 2010. Both data sets were obtained from ProPublica.
The SSRN report concludes that a physician is more likely to prescribe a company’s drug when he/she receives a payment from the company. On average, the payment corresponds to an additional 29 Medicare prescriptions per year and nearly 100 prescriptions per year if the payment is at least $1000. The SSRN report also finds higher correlations between male physicians and physicians in “high-corruption states.”
Notably, the payments reported by these companies were not standardized. These payments were largely reported in accordance with corporate integrity agreement (CIA) obligations. These CIA obligations generally change over time by requiring certain categories of payments to be reported in year one and additional categories in subsequent years.
Regardless of whether one agrees with the SSRN report methodology and conclusions, it is safe to say that we will see more of these analyses as more comprehensive data is reported under the Sunshine Act.